Relationships Among PTSD, Preventive and Risky Behaviors, and Health Outcomes

Abstract

Individuals with posttraumatic stress disorder (PTSD) are more likely to demonstrate increases in self-reported physical health complaints, objective markers of poor health, health care utilization, and mortality. Although this relationship has been well-established in trauma literature, the mechanisms underlying this association are not well understood. One proposed hypothesis to account for this relationship is the behavioral pathway, which suggests that individuals with PTSD are more likely to engage in risky health behaviors (e.g., substance use) that, in turn, result in poor health outcomes. The current study proposed to expand the behavioral pathway to include preventive health behaviors (e.g., regular exercise). It was hypothesized that (1) PTSD would be highly correlated with poor health outcomes, (2) PTSD would be positively correlated with engagement in risky health behaviors and negatively correlated with engagement in preventive health behaviors, (3) risky health behaviors would mediate the relationship between PTSD and poor health outcomes, and (4) the absence of preventive health behaviors would serve as a mediator between PTSD and physical health outcomes. One hundred and sixty trauma-exposed undergraduates completed a self-report battery including measures assessing PTSD symptoms, risky and preventive health behaviors, and health outcomes. Consistent with hypothesis 1, PTSD was significantly correlated with poor physical health outcomes, though PTSD symptoms did not predict engagement in risky or preventive health behaviors and meditational hypotheses were not supported. These findings call attention to the well-known relationship between PTSD and physical health. However, the mechanisms by which physical health is impacted by PTSD remain unclear.